While assisting a veteran with a claim related to psychiatric disabilities, you will likely come across so-called “GAF” scores, the acronym referring to Global Assessment of Functioning under the DSM-IV.[1] These scores show up in treatment records and VA examination reports as inconspicuous notations, usually found at the conclusion of a medical opinion or treatment report. They are easily overlooked,but can be helpful in establishing your client’s entitlement to a higher disability rating.
A GAF score represents “the clinician’s judgment of the individual’s overall level of functioning…. DIAGNOSTIC AND STATISTICAL MANUAL OF MENTAL DISORDER 30 (4th ed. 1994). GAF scores have a numeric value from 1-100, with the severity of the disability going up as the GAF score goes down. The GAF scale breaks down as follows:
Keep an eye out for GAF scores of 50, a frequently assigned score. Many veterans with this score are under-rated for VA disability purposes, having disability awards of fifty (50) percent or less. A GAF score of 50 corresponds, (or should correspond),to a seventy (70) percent disability rating or greater under the VA schedule. See Bowling v. Principi, 15 Vet. App. 1, 14 (2001) (citing Richard (Mary) v. Brown,9 Vet. App. 266, 267 (1996)) (the Court recognized that a veteran with a GAF score of 50 was rated at 70 percent).
In this regard, point out to the rating specialist or Decision Review Officer that the criteria for a GAF score of 50 (emboldened above) correlates with those for a seventy (70) percent disability rating under Diagnostic 9400, (the diagnostic code for mental disorders):
70% (Occupational and social impairment, with deficiencies in most areas, such as work, school, family relations, judgment, thinking, or mood, due to such symptoms as: suicidal ideation; obsessional rituals which interfere with routine activities;speech intermittently illogical, obscure, or irrelevant; near-continuous panic or depression affecting the ability to function independently, appropriately and effectively;impaired impulse control (such as unprovoked irritability with periods of violence);spatial disorientation; neglect of personal appearance and hygiene; difficulty in adapting to stressful circumstances (including work or a work like setting); inability to establish and maintain effective relationships . . . ).
And do not forget requests for Total Disability based on Individual Unemployability(TDIU) ratings. A seventy (70) percent disability rating usually means the veteran is not working. If so, a request for a total disability rating based upon individualun employability (TDIU) should be raised along with the psychiatric claim. To learn more about TDIU, please see our recent Webinar on this subject.
[1] The GAF assessment has been eliminated under the DSM-V.